September 28, 2013
September 23, 2013
To Eat & To Watch: 30 and chick peas
In my new (old) obsession with TedTalks while cooking, I serve you Psychologist Meg Jay talking about some lessons for your 20s and a recipe for a dutch baby pancake.
TO WATCH: Meg Jay
TO WATCH: Meg Jay
"the only things required to do something meaningful
are a good idea and not quite enough time"
(or something close to that)
A Summary of her Advice to 20-somethings:
(1) - forget about having an identity crisis and get some identity capitol
(2) -work your friends-of-friends-of-friends connections, they might lead you to your next love, job, house, true friend/family
(3) -choose your family of friends intentionally
TO EAT:
Chickpea Salad
(adapted from Martha Stewart's Meatless Mondays)
I'm actually obsessed with chick peas and for some reason, when you bake them they take on this most unexpected, kind of salty, very spicy, super fun flavor.
ingredients:
chickpeas, paprika, garam masala, olive oil, salad greens, tahini, cucumbers
1. heat oven to 350 degrees F
2. drain chickpeas and rinse with cold water, dry a little bit with a towel or paper towels
3. spread the chickpeas on a baking sheet
4. sprinkle olive oil (just a little bit) on top and roll the chick peas in it so they're coated
5. add your paprika, salt, pepper, garam masala and roll the chickpeas again so they're covered
6. bake in oven for 30-40min
7. while they're baking, chop cucumber and prepare salad greens
8. take chick peas out of oven and pour onto salad greens and add chopped cucumber
9. drizzle with tahini and ta-da! chickpea salad for you!
September 14, 2013
Autumn Reading List
one of my dreams since moving to DC has been to join a book club. it seems like everyone is in them here. I want to be one of the people who meets up with brilliant, clever, funny people to discuss how a book made them think, feel, wonder differently about the world. I'm in the process of scouting a few book club options, but in the meantime, here's my personal fall reading list:
1. When Everything Changed by Gail Collins
a nonfiction account about the truth, myths and mystery in the US women's revolution
2. The Fault in Our Stars by John Green
nonfiction account of a 16yo with terminal cancer who is just. so. freaking. hilarious and profound
3. A Suitable Boy by Vikram Seth
a full immersion story about relationships and life in India
4. Expecting Better by Emily Oster
a chicago economist takes on the data about pregnancy recommendations
5. Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande (a re-read)
a book about how medicine is human
6. The Collected Work of Nikki Giovanni by Nikki Giovanni
a book of poetry by one of the most wonderful modern poets
7. A Spiritual Guide to Midwifery by Ida May Glass
a nonfiction account of Ida May's midwifery practice from beginning to present day
8. A Practical Wedding by Meg Keene
because, you know, I'm planning a wedding but don't want to be a crazy, silly bride
9. Let's Explore Diabetes with Owls by David Sedaris
my official book club book and one of the FUNNIEST authors ever. I'm so excited
10. The Guernesy Literary and Potato Peel Pie Society by Mary Ann Shaffer
recommended by several friends, entirely of letters during WW2
what's on your reading list? what should I add to mine?
Also, I love the paintings of people's bookshelves in Jane Mount's book - I keep thinking about what would be on my idea bookshelf. Maybe at some point I'll have to actually design one and draw it out.
photo credit: idealbookshelf by Jane Mount
September 11, 2013
two stories: 9/2013
story 1*
After a month in the ICU, I worry I've become cynical. Not because I don't believe in the power and might of modern medicine but because I worry that we use it too much instead of trying to help people cope with questions of happiness and mortality, quality and quantity of life. Since my month has started, several patients have died in the ICU, all of them incredibly sick and all of the stories incredibly sad. It's often a burden to carry the knowledge I've worked so hard to obtain about human physiology and pathology of different disease processes because it's often so much more obvious to me (and to the rest of the medical team) than to the patient's family that the patient - their husband, daughter, wife, brother - is not going to get better.
But this week I'm more optimistic. I've been talking a lot with the partner of one of my patients, let's call the patient Tom and the partner Pat. A few days ago (when I'm writing this, not when I'm actually publishing it) Pat was incredibly overwhelmed with grief. Tom had been intubated for over a week and didn't appear to be getting any better. Pat was plagued by the big questions that arise whenever a loved one is incapacitated and decisions have to be made by loved ones, including "is this what he would have wanted?" Tom had come in directly from an ambulance after a motorcycle accident, had fractured his pelvis, arms, and legs, and had suffered multiple abdominal injuries requiring the placement of a feeding tube to give his intestines some time to heal. He had also been intubated with an endotracheal tube and put on a breathing machine. Tom had been through multiple surgeries at this point, had been given so much fluid to try to keep his blood pressure high enough to perfuse his brain and other organs that his skin was stretched and puffy. His bruises that formed after the accident were turning every shade from blue to yellow and gave his skin a patchy appearance. I talked to Pat most days and updated him about how we were caring for Tom and answered his questions about next steps. But yesterday, Pat took me aside and just said to me, look. I just want to know if you think he's going to get better, because I have to tell you, I'm getting discouraged. Every day it looks like he is in more pain, is more bloated, and getting worse. And I totally got it. Tom DID look horrible in lots of ways - the tubes, the lines, the sedation, the bloating, I tried to make myself see the picture that Pat was seeing so that I could fully understand. But strangely, after four years of medical school and three months of intern year, everything I know now makes me look at Tom with great optimism; he's the kind of person who truly gets better in an ICU. He had his reconstructive orthopedic (bone) surgery and it went really well. The drains in his abdomen were taking care of a lot of the fluid. His kidney tests looked great. All of the cultures we had taken showed that he didn't have any infections. Yes, he was sedated and using the tube to breath, but that wasn't because he necessarily couldn't breathe without it, it's that we we still determining if it could be removed, and were therefore sedating him so that he wasn't (appropriately) agitated by having a tube down his throat. So I went through all of that - or most of it - with Pat and said, I know it doesn't look like it to you, but Tom really is getting better. And Pat believed me, and it gave him hope. I left for home that day thinking that it's these moments when I feel the most privileged, helpful, and just so proud of how hard I have worked to gain this knowledge and the skills to be able to explain them to help people cope.
story 2.
A few weekends ago, on a unique day off together, my husband-of-the-future and I biked to a farmers market in town. We bought tomatoes, cheese, garlic, and iced coffee, wandered around a bit more checking out all the stalls, and then decided to bike home. Our bike home took us on a bike path along a busy city street. We were talking about what we were going to make for dinner when all of a sudden a motorcycle swerved into the intersection just as a taxi cap decided it would try to make the last second of a yellow light and the two collided in a loud crash. Without pausing for one moment, both Chris and I biked right up to the accident, threw our bikes on the ground and went to the side of the motorcycle rider to assess him. I'm sure if we had been a movie, the screen would have zoomed in on our minds scanning the scene for dangers, looking at the man to see if he was moving, breathing and if there was blood. You would have seen us click through the steps of out-of-hospital resuscitation including CPR and rescue breathing.
And there may have been a flashback to another bike ride, in another time, when I didn't know what to do, didn't know how to be responsible for someone being injured, and instead of jumping into action, I froze.
The man turned out to be just fine. He probably broke his ankle, but was otherwise completely injury free, just angry with the taxi driver. During our assessment, other people had called 911, so by the time we were helping him move to the side of the curb, a fire truck was already arriving on the scene. All in all, we didn't do much, but the fact that neither of us paused to think we didn't have the knowledge or the skills, but knew confidently that we did, was an amazing feeling in which to revel afterward.
*like all my stories about patients and my work, many details have been changed to protect the patient's and hospital's confidentiality, but the meaning is all true.
After a month in the ICU, I worry I've become cynical. Not because I don't believe in the power and might of modern medicine but because I worry that we use it too much instead of trying to help people cope with questions of happiness and mortality, quality and quantity of life. Since my month has started, several patients have died in the ICU, all of them incredibly sick and all of the stories incredibly sad. It's often a burden to carry the knowledge I've worked so hard to obtain about human physiology and pathology of different disease processes because it's often so much more obvious to me (and to the rest of the medical team) than to the patient's family that the patient - their husband, daughter, wife, brother - is not going to get better.
But this week I'm more optimistic. I've been talking a lot with the partner of one of my patients, let's call the patient Tom and the partner Pat. A few days ago (when I'm writing this, not when I'm actually publishing it) Pat was incredibly overwhelmed with grief. Tom had been intubated for over a week and didn't appear to be getting any better. Pat was plagued by the big questions that arise whenever a loved one is incapacitated and decisions have to be made by loved ones, including "is this what he would have wanted?" Tom had come in directly from an ambulance after a motorcycle accident, had fractured his pelvis, arms, and legs, and had suffered multiple abdominal injuries requiring the placement of a feeding tube to give his intestines some time to heal. He had also been intubated with an endotracheal tube and put on a breathing machine. Tom had been through multiple surgeries at this point, had been given so much fluid to try to keep his blood pressure high enough to perfuse his brain and other organs that his skin was stretched and puffy. His bruises that formed after the accident were turning every shade from blue to yellow and gave his skin a patchy appearance. I talked to Pat most days and updated him about how we were caring for Tom and answered his questions about next steps. But yesterday, Pat took me aside and just said to me, look. I just want to know if you think he's going to get better, because I have to tell you, I'm getting discouraged. Every day it looks like he is in more pain, is more bloated, and getting worse. And I totally got it. Tom DID look horrible in lots of ways - the tubes, the lines, the sedation, the bloating, I tried to make myself see the picture that Pat was seeing so that I could fully understand. But strangely, after four years of medical school and three months of intern year, everything I know now makes me look at Tom with great optimism; he's the kind of person who truly gets better in an ICU. He had his reconstructive orthopedic (bone) surgery and it went really well. The drains in his abdomen were taking care of a lot of the fluid. His kidney tests looked great. All of the cultures we had taken showed that he didn't have any infections. Yes, he was sedated and using the tube to breath, but that wasn't because he necessarily couldn't breathe without it, it's that we we still determining if it could be removed, and were therefore sedating him so that he wasn't (appropriately) agitated by having a tube down his throat. So I went through all of that - or most of it - with Pat and said, I know it doesn't look like it to you, but Tom really is getting better. And Pat believed me, and it gave him hope. I left for home that day thinking that it's these moments when I feel the most privileged, helpful, and just so proud of how hard I have worked to gain this knowledge and the skills to be able to explain them to help people cope.
story 2.
A few weekends ago, on a unique day off together, my husband-of-the-future and I biked to a farmers market in town. We bought tomatoes, cheese, garlic, and iced coffee, wandered around a bit more checking out all the stalls, and then decided to bike home. Our bike home took us on a bike path along a busy city street. We were talking about what we were going to make for dinner when all of a sudden a motorcycle swerved into the intersection just as a taxi cap decided it would try to make the last second of a yellow light and the two collided in a loud crash. Without pausing for one moment, both Chris and I biked right up to the accident, threw our bikes on the ground and went to the side of the motorcycle rider to assess him. I'm sure if we had been a movie, the screen would have zoomed in on our minds scanning the scene for dangers, looking at the man to see if he was moving, breathing and if there was blood. You would have seen us click through the steps of out-of-hospital resuscitation including CPR and rescue breathing.
And there may have been a flashback to another bike ride, in another time, when I didn't know what to do, didn't know how to be responsible for someone being injured, and instead of jumping into action, I froze.
The man turned out to be just fine. He probably broke his ankle, but was otherwise completely injury free, just angry with the taxi driver. During our assessment, other people had called 911, so by the time we were helping him move to the side of the curb, a fire truck was already arriving on the scene. All in all, we didn't do much, but the fact that neither of us paused to think we didn't have the knowledge or the skills, but knew confidently that we did, was an amazing feeling in which to revel afterward.
*like all my stories about patients and my work, many details have been changed to protect the patient's and hospital's confidentiality, but the meaning is all true.
September 9, 2013
To Eat & To Watch: manipulating the data
I've started a tradition (or habit?) where I watch Ted Talks while I cook, so perhaps this is a new tradition of a post that combines a must-watch TedTalk video and a must-eat recipe. If you've never heard of TedTalks, I highly suggest you check them out. It's a database of hundreds (thousands? hundreds of thousands?) of people talking about the most fascinating topics, and the best part is, every one has to be less than 20 minutes, so they are concise and profound without ever getting boring. Here's one of my new favorites by Hans Rosling explaining (visually and like a sports caster) how our world dynamics are changing. I may be a little biased because he starts out by talking about how we all assume that The Western World = long lives and small families and The Third World = short lives and big families, and then goes on to debunk it all. Enjoy!
For more fun visualization of populations, check out this Racial Dot Map, from the Welden Cooper Center for Public Service.
Recipe: Shrimp Avocado Salsa
(adapted from Smitten Kitchen's Mama Canales-Garcia's Shrimp Avocado Salsa)
(photo credit: smitten kitchen blog)
ingredients&instructions:
-1 lb shrimp - de-vein the shrimp and take the shell taken off. boil a pot of water, then turn off, throw shrimp in and cover for 5-7 minutes. ta-da! cooked shrimp! now chop into small pieces.
-2 avocados - chop into small pieces and put into a large bowl
-1 jalapeno (or less or more depending on your spicy preferences) - chop into small pieces
-3 tomatoes or a whole bunch of little grape/cherry tomatoes - chop into small pieces (you see where I'm going with this, right?)
-2 limes - squeeze all the juice in! you really can't have too much
-splash of olive oil, a dash of salt, a shake of pepper
combine altogether, serve with cilantro, tortillas and/or good bread. we ate ours with a decided-ly not mexican bagette and it was delicious.
Recipe: Shrimp Avocado Salsa
(adapted from Smitten Kitchen's Mama Canales-Garcia's Shrimp Avocado Salsa)
(photo credit: smitten kitchen blog)
ingredients&instructions:
-1 lb shrimp - de-vein the shrimp and take the shell taken off. boil a pot of water, then turn off, throw shrimp in and cover for 5-7 minutes. ta-da! cooked shrimp! now chop into small pieces.
-2 avocados - chop into small pieces and put into a large bowl
-1 jalapeno (or less or more depending on your spicy preferences) - chop into small pieces
-3 tomatoes or a whole bunch of little grape/cherry tomatoes - chop into small pieces (you see where I'm going with this, right?)
-2 limes - squeeze all the juice in! you really can't have too much
-splash of olive oil, a dash of salt, a shake of pepper
combine altogether, serve with cilantro, tortillas and/or good bread. we ate ours with a decided-ly not mexican bagette and it was delicious.
September 8, 2013
august 2013
I know I've taken a late summer break from blogging about life/work as an ob-gyn intern, but I have lots of good reasons:
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a hike in great falls
a wedding in calfornia (on a boat! with all my future inlaws!)
bike ride dates with my ladies in the city
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another wedding in california!
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okay, this one's from the beginning of the summer, but sums up how I feel about summer in a nutshell:
(stay tuned for more serious thoughts on being an intern,
I'm finishing up an ICU rotation -
and have had lots to think about):
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